FeaturesAug/Sep 2010 Issue

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Celiac Triggers

Other environmental factors could be relevant to the onset of celiac disease in genetically predisposed individuals.

Breastfeeding

Researchers have debated whether breastfeeding just delays or alters the presentation of celiac—from the symptomatic to the asymptomatic form. Most evidence now suggests that breastfeeding is actually protective. Why breastfeeding has this effect is still unclear.

Gluten and Infants

Following a dramatic up-tick in celiac diagnoses among young children in Sweden in the mid-1990s, researchers hypothesized that infant feeding practices could have an impact on the development of the disease. Prior to the rise in celiac cases, breastfeeding had been on the decline and gluten was being introduced earlier and in larger amounts.

Based on these observations, experts recommend that gluten introduction be delayed until 4 to 6 months of age and be given in small amounts. They also recommend breastfeeding while introducing gluten.

Smoking

While very controversial, a few scientific papers suggest smoking may be protective against the development of celiac disease, says Peter H.R. Green, MD, director of the Celiac Disease Center at Columbia University. The mechanisms are unknown. Celiac experts strongly caution that smoking is not healthy and that any connection between smoking, nicotine and the onset of celiac disease is of interest to researchers solely for the purpose of better understanding the disease.